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Belghith C, Abdelmoula G, Garci M, Ghali Z, Armi S, Makni M, Dhieb F, Boumediene M, Jrad M, Mathlouthi N, Slimani O. Nonpuerperal uterine inversion caused by an adenosarcoma: A case report. Tunis Med 2024; 102:116-118. [PMID: 38567479 DOI: 10.62438/tunismed.v102i2.4352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/29/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Eighty-five per cent of uterine inversions are puerperal. Non-puerperal uterine inversion is usually caused by tumours that exert a traction force on the fundus of the uterus. This causes the uterus to be partially or completely inverted. It is commonly related to benign tumours like submucosal leiomyomas. Nevertheless, malignancies are an infrequent association. CASE PRESENTATION We report a case of a 35-year-old female patient, medically and surgically free, gravida0 para0, complaining of menometrorrhagia associated with pelvic pain for 2 years. A suprapubic ultrasound scan showed an enlarged, globular uterus with a heterogeneous, undefined mass of 49 mm in size. MRI scan showed the appearance of a U-shaped uterine cavity and a thickened inverted uterine fundus with an endometrial infiltrating mass of 25 mm. Intraoperative exploration showed uterine inversion involving the ovaries; the fallopian tubes and the round ligaments and a necrotic intracavitary mass. The malignancy of the tumor was confirmed through anatomopathological examination as Adenosarcoma. CONCLUSIONS Uterine inversion is rare outside the puerperal period, and malignant etiology must not be overlooked. Therefore, comprehensive care with meticulous etiological investigation is crucial.
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Affiliation(s)
- Cyrine Belghith
- University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunis, Tunisia
- Charles Nicolle University Hospital of Tunis, Department A of Gynecology and Obstetrics, 1006, Tunis, Tunisia
| | - Ghada Abdelmoula
- Charles Nicolle University Hospital of Tunis, Department A of Gynecology and Obstetrics, 1006, Tunis, Tunisia
- University of Sousse, Faculty of medicine of Sousse, 4000, Sousse, Tunisia
| | - Mariem Garci
- University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunis, Tunisia
- Charles Nicolle University Hospital of Tunis, Department A of Gynecology and Obstetrics, 1006, Tunis, Tunisia
| | - Zeineb Ghali
- University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunis, Tunisia
- Charles Nicolle University Hospital of Tunis, Department A of Gynecology and Obstetrics, 1006, Tunis, Tunisia
| | - Saoussam Armi
- University of Sousse, Faculty of medicine of Sousse, 4000, Sousse, Tunisia
- Regional hospital of Kasserine, Department of gynecology and obstetrics, 1200, Kasserine, Tunisia
| | - Mehdi Makni
- University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunis, Tunisia
- Charles Nicolle University Hospital of Tunis, Department A of Gynecology and Obstetrics, 1006, Tunis, Tunisia
| | - Fatma Dhieb
- University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunis, Tunisia
- Charles Nicolle university hospital, Department of radiology, 1006, Tunis, Tunisia
| | - Miriam Boumediene
- University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunis, Tunisia
- Charles Nicolle university hospital, Department of radiology, 1006, Tunis, Tunisia
| | - Myriam Jrad
- University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunis, Tunisia
- Charles Nicolle university hospital, Department of radiology, 1006, Tunis, Tunisia
| | - Nabil Mathlouthi
- University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunis, Tunisia
- Charles Nicolle University Hospital of Tunis, Department A of Gynecology and Obstetrics, 1006, Tunis, Tunisia
| | - Olfa Slimani
- University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunis, Tunisia
- Charles Nicolle University Hospital of Tunis, Department A of Gynecology and Obstetrics, 1006, Tunis, Tunisia
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Abid S, Dhaou GB, Abdelmoula G, Smida AB, Abdesslem MRB, Mrad O, Derouiche M, Lassoued L. Complete non-puerperal uterine inversion caused by uterine hemangioma: a case report. Pan Afr Med J 2022; 42:156. [PMID: 36187039 PMCID: PMC9482224 DOI: 10.11604/pamj.2022.42.156.35583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/10/2022] [Indexed: 11/23/2022] Open
Abstract
Uterine inversion is a rare postpartum complication. It is a rare condition in which the internal surface of the uterus protrudes through the vagina. Non-puerperal uterine inversion (NPUI) is extremely rare. In most instances, it is linked to uterine tumors. Among these tumors, leiomyoma is the most frequent cause reported in data. This condition may not be noticed until time of surgery. Malignancy is suspected in most cases. Nevertheless, uterine inversion can be diagnosed preoperatively using radiology. Difficulties in diagnosing NPUI makes this clinical case a challenge in gynaecology and not commonly reported in literature. We report our experience in the diagnosis and treatment of a complete non-puerperal uterine inversion associated with uterine angioleiomyoma. The patient's age was 44, gravida 2 para 1 presented with intermittent vaginal bleeding for four months and an acute abdominal cramping pain. On examination, a large mass lesion was observed which occupies the vaginal cavity and the contour of the uterine cervix could not be reached. Biopsies and Immunohistochemistry matched with an angioleiomyoma. She underwent a transvaginal surgical reposition technique: Spinelli’s. It is important to diagnose accurate non-puerperal uterine inversion. Surgery provides good prognosis and it is necessary. We report a case of NPUI caused by angioleiomyoma. Nevertheless, malignancy must be eliminated in first place.
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Affiliation(s)
- Skander Abid
- University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia
- Farhat Hached University Hospital of Sousse, Department of Obstetric Gynecology, 4000, Sousse, Tunisia
- Corresponding author: Skander Abid, University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia.
| | - Ghassen Ben Dhaou
- University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia
- Farhat Hached University Hospital of Sousse, Department of Obstetric Gynecology, 4000, Sousse, Tunisia
| | - Ghada Abdelmoula
- University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia
- Farhat Hached University Hospital of Sousse, Department of Obstetric Gynecology, 4000, Sousse, Tunisia
| | - Ahmed Ben Smida
- University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia
- Farhat Hached University Hospital of Sousse, Department of Obstetric Gynecology, 4000, Sousse, Tunisia
| | - Mohamed Raouf Ben Abdesslem
- University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia
- Farhat Hached University Hospital of Sousse, Department of Obstetric Gynecology, 4000, Sousse, Tunisia
| | - Ons Mrad
- University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia
- Farhat Hached University Hospital of Sousse, Department of Obstetric Gynecology, 4000, Sousse, Tunisia
| | - Mouna Derouiche
- University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia
- Farhat Hached University Hospital of Sousse, Department of Obstetric Gynecology, 4000, Sousse, Tunisia
| | - Latifa Lassoued
- University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia
- Farhat Hached University Hospital of Sousse, Department of Obstetric Gynecology, 4000, Sousse, Tunisia
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